Evaluation of the effectiveness of liraglutide and sitagliptin in type 2 diabetes: a retrospective study in UK primary care

OBJECTIVE: Type 2 diabetes is a chronic condition that continues to increase in prevalence in the UK. Incretin-based therapies, including liraglutide and sitagliptin, provide adequate blood glucose control. Clinical trials have shown that liraglutide offers greater glycaemic control and body weight reduction in comparison to sitagliptin. We aimed to assess the effectiveness of liraglutide and sitagliptin in routine clinical practice. MATERIALS AND METHODS: We designed and conducted a retrospective database analysis in primary care using the Clinical Practice Research Datalink in the UK. Patients aged ≥ 18 years, diagnosed with type 2 diabetes and prescribed liraglutide or sitagliptin between July 2009 and July 2012, were included in the study. Glycaemic and weight control were investigated 6 months after treatment initiation. RESULTS: A total of 287 liraglutide and 2781 sitagliptin patients were identified. Compared with sitagliptin, liraglutide recipients had greater reductions in HbA1c (%) (-0.90 vs. -0.57, p < 0.01), weight (kg) (-3.78 vs. -1.12, p < 0.001), BMI (kg/m(2) ) (-1.30 vs. -0.39, p < 0.001) and systolic blood pressure (mmHg) (-3.91 vs. -0.39, p < 0.001) after 6 months of treatment. When controlling for potential confounders, liraglutide was more likely than sitagliptin to achieve an HbA1c reduction ≥ 1% (OR = 2.29, 95% CI 1.62-3.25), an HbA1c reduction ≥ 1% and a weight reduction ≥ 3% (OR = 2.99; 95% CI 2.00-4.48) and a target HbA1c < 7% (OR = 2.11; 95% CI 1.45-3.07) after 6 months of treatment. CONCLUSIONS: Clinical trials show superior glycaemic control and weight reduction with liraglutide compared with sitagliptin. This finding is reflected in routine clinical practice in the UK.